Fatal hypoglycaemia in insulin-treated diabetes mellitus: clinical features and neuropathological changes

Diabet Med. 1990 May;7(4):349-54. doi: 10.1111/j.1464-5491.1990.tb01403.x.


Four insulin-treated diabetic patients presented over a 2-year period in hypoglycaemic coma and died secondary to this. At autopsy, there were widespread neuropathological changes, in all four cases consistent with hypoglycaemic damage. Abnormalities were also found in areas regarded as generally being spared in hypoglycaemic brain injury, particularly the brain stem, thalamus, globus pallidus, and cerebellum, and these lesions may relate to seizure activity and cardio-respiratory depression secondary to the hypoglycaemia. Although more than one aetiological factor may be contributing, it is concluded that the neuropathological changes in diabetic patients dying in hypoglycaemic coma are extremely diverse.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Blood Glucose / analysis
  • Brain / drug effects
  • Brain / pathology
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / chemically induced
  • Hypoglycemia / mortality*
  • Insulin / adverse effects*
  • Insulin / blood
  • Insulin / therapeutic use
  • Male


  • Blood Glucose
  • Insulin